Ann McNeill Speaking Event Questionnaire
Thank you for your interest in booking Ann McNeill for your upcoming event. Please complete the form below.
Part 1: Primary Contact
Date of Request
*
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Month
-
Day
Year
Date
Sponsoring Organization
*
Main Contact
*
First Name
Last Name
Title
*
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Part 2: Secondary Contact
Secondary Contact
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Part 3: Event & Program Details
Date of Event
*
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Month
-
Day
Year
Date
Time of Event
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Program name
*
Program Theme
Program Focus
*
Type of Event
*
In-Person
Virtual
Hybrid
Budget for Speaker Fee
*
Name of Venue
*
Type of Venue
*
Hotel, Convention Center. University
Venue Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Requested Topic/Subject
*
Length of Time for Presentation
*
Length of Time for Q & A
Time of Ann's Presentation
Additional Information
Type of Program
*
Keynote Speaker
Panel Discussion
Workshop
Presentation
Staff Training
Webinar
Podcast
Other
Ann is the Owner of multiple businesses and founder of multiple civic organizations. Please share what organization platform you are asking her to speak from.
*
MCO Construction
MCO Consulting
NABWIC (Natl Assoc. of Black Women in Construction)
CSI (Constructivley Speaking Inc., personal & professional development
IMA (International Mastermind Assoc)
Unsure
Other
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Part 4: Audience Information
Who is Your Audience:
*
Estimated Number of Attendees:
*
Audience Ethnicity:
What Would You Most Like Your Audience To Experience?
*
More Information:
Part 5: Marketing
Confirm event manager will send a draft copy of the program during/ immediately after this call. (Confirmed once received)
*
Yes
No
Social Media Marketing Handles
Who will Market Event?
Where will the Event Be Marketed?
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Part 6: Who Is Responsible for Payment and Transportation of Speaker?
Including Honorarium/Fee, Travel, and Accommadations
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
More Information
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Part III: Additional Information Needed
Will you Provide Ann McNeill your Attendance List?
*
Yes
No
Will Ann be able to bring/market products for sale or upcoming events by Ann McNeill?
*
Yes
No
Will you supply a booth or display for Ann's products?
Yes
No
Will you provide an assistant for Ann(product table, etc.)?
Yes
No
Will you provide Ann with photos and/or video/audio recordings of the event/activity?
*
Yes
No
What Meetings and Events Will Ann McNeill Be Expected to attend?
Anything Else We Need to Know to be of Maximum Service to You?
Submit
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